TY - JOUR
T1 - The Impact of Psychosocial Factors on Health and Retention Outcomes for People Living With HIV
T2 - Implications for Rehabilitation Counselors and Educators
AU - Chiu, Yung Chen Jen
AU - Boomer, K. B.
AU - Conyers, Liza M.
N1 - Funding Information:
We would like to thank Dr. John Zurlo, medical director of the Department of Infectious Disease at Penn State Hershey Medical Center who provided the clinic data set and consultation for this study. Dr. Tonya Crook and Mr. Michael Witmer at the clinic also shared their rich clinical experiences that allowed us to interpret the study results in a practical way. The authors received no financial support for the research, authorship, and/or publication of this article.
Publisher Copyright:
© Hammill Institute on Disabilities 2018.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Despite medical advancements that have significantly improved the health outcomes of people living with HIV (PLWH), many do not achieve optimal health outcomes due to psychosocial barriers. This 5-year retrospective longitudinal study draws upon the International Classification of Functioning, Disability, and Health (ICF) framework to conceptualize the relationships between personal and environmental factors and health and retention outcomes among a sample of 704 PLWH in Pennsylvania. A generalized estimated equations (GEE) model was used to model retention in care outcomes (at least one medical visit every 6 months) and a general linear mixed (GLM) model was used to analyze immune system health outcomes (CD4%). This exploratory study reveals that gender, age, race, use of antiretroviral (ARV) medications, use of case management service, mental health diagnosis, and alcohol use were significantly associated with retention in care, whereas race, ethnicity, gender, mental health treatment, use of ARV medications, use of case management services, and retention in care status were significantly associated with the immune system health outcome of CD4%. The results suggest a need for rehabilitation interventions to address key psychosocial issues, as rehabilitation counselors have a unique skill set to address the medical case management needs of individuals with HIV. Implications for rehabilitation counselors and educators are discussed.
AB - Despite medical advancements that have significantly improved the health outcomes of people living with HIV (PLWH), many do not achieve optimal health outcomes due to psychosocial barriers. This 5-year retrospective longitudinal study draws upon the International Classification of Functioning, Disability, and Health (ICF) framework to conceptualize the relationships between personal and environmental factors and health and retention outcomes among a sample of 704 PLWH in Pennsylvania. A generalized estimated equations (GEE) model was used to model retention in care outcomes (at least one medical visit every 6 months) and a general linear mixed (GLM) model was used to analyze immune system health outcomes (CD4%). This exploratory study reveals that gender, age, race, use of antiretroviral (ARV) medications, use of case management service, mental health diagnosis, and alcohol use were significantly associated with retention in care, whereas race, ethnicity, gender, mental health treatment, use of ARV medications, use of case management services, and retention in care status were significantly associated with the immune system health outcome of CD4%. The results suggest a need for rehabilitation interventions to address key psychosocial issues, as rehabilitation counselors have a unique skill set to address the medical case management needs of individuals with HIV. Implications for rehabilitation counselors and educators are discussed.
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U2 - 10.1177/0034355218755304
DO - 10.1177/0034355218755304
M3 - Article
AN - SCOPUS:85042081362
SN - 0034-3552
VL - 62
SP - 94
EP - 107
JO - Rehabilitation Counseling Bulletin
JF - Rehabilitation Counseling Bulletin
IS - 2
ER -